400-bed acute care rehabilitation hospital, one with facilities to diagnose and treat patients on an inpatient basis, is planning to implement additional wireless applications on its existing Wi-Fi network. The overarching goals of this project are to increase productivity by getting information to mobile workers more
efficiently and to reduce medication dosing errors. These applications will use the existing Wi-Fi network that will be expanded as required to support use for visitors, existing applications, and new applications.
Most of the rehabilitation facility’s employees are mobile and not assigned to a fixed desk with a telephone and computer. Doctors and nurses are more productive when they have access to patient information remotely, at patient bedsides or near patient rooms. This enables them to input data such as current status on
vital signs directly into a computer. Previously, doctors and nurses wrote this data on paper and then had someone else input the data at a centralized station.
The new wireless applications will save time and provide important tools to doctors because they will be able to write prescriptions at the patient’s bedside.
The applications will additionally provide realtime information on drug interactions
with drugs patients are already taking. Staff members will also be able to
research unusual disorders directly when they are with patients. By providing
tools for medical personnel that they can use on a mobile basis, the hospital will
improve staff productivity and decrease the chance of transcription errors.
The IT staff is planning to implement a broad program that utilizes iPad tablet computers and new workstations to enable nurses and doctors to be closer to patients and save time on accessing and inputting patient information. The following are key initiatives.
Provide iPads to doctors for use during their rounds. The doctors will Hospitals by Using Wireless Service fixed have access to patient information such as laboratory results and the ability to update information on patient conditions as needed during rounds.
The hospital is considering providing smartphones to nurses and doctors so that they can communicate directly with one another.
Changes in the floor layouts will bring access to computers nearer to medical staffs on patient floors so that they remain closer to patients.
Rather than the current hub-and-spoke design in which the nurses’ station and computers are centralized, one computer workstation will be located between every two patient rooms. The workstation will be for short-term tasks such as entering patient data including blood pressure and heart rate. It will be located in a recessed nook where nurses will stand to input patient information. In addition, there will be cubby-like spaces at which nurses can sit down at computers for tasks that take longer to accomplish, such as writing intake and discharge reports.
The hospital is instituting the use of barcode scanners to minimize
container. A green LED on the scanner indicates that the medication is
errors in dispensing medication. Every time a nurse administers medication
for infusion or oral intake, she scans the bar code on her own
identification badge, the patient’s wrist bracelet, and the medication
correct; red indicates an error. The scanners will be connected to computers that are hardwired to a mobile cart.
As a supplement to other therapies, speech and occupational therapists already use iPads and Wii game consoles with special programs that are used to enhance cognitive and keyboard therapies.
The most difficult challenge in deploying new applications is user acceptance.
There are 400 nurses in the facility and most of them did not grow up with this degree of technology. They resist using applications that they perceive as adding to their workload. Therapists, doctors, and nurses all want easy-to-use applications that require little or no training. To overcome possible resistance, the hospital
brought in three mobile carts, each configured differently, and let the nurses try them all out and recommend the one they liked best.
To ensure acceptance and success of the bar code scanning initiative, the hospital conducted a survey to ensure that the wireless network was adequate. Dead spots or difficulties accessing the central drug-dispensing database can lead to resistance in adopting the scanners. The hospital hired consultants to conduct the
wireless audit to determine if there were dead spots in wireless Wi-Fi coverage. The consultants wheeled medical carts with bar code scanners throughout the facility to ensure that there was satisfactory coverage everywhere. The IT department is adding access points where needed for uniform Wi-Fi coverage.
In addition to user acceptance, infection control is a major concern when any hospital deploys new technologies. All keyboards, mice, scanners, and tablet computers need to be protected by rubberized covers to eliminate any nooks and crannies in which bacteria can form. This also permits these devices to be wiped
down with antibacterial cleaning fluid without damaging the equipment.
Hospitals are also heavily regulated in terms of security and privacy requirements.
These regulations require that all wireless devices are capable of using the centralized system that encrypts wireless transmissions. Access to patient information must be password protected. As a further protection, all web sites that hospital visitors and staff members access via the hospital’s wireless and
wireline networks are probed for malware so that viruses do not contaminate the hospital network or compromise patient privacy. The security software blocks access to web sites found to have malware.